Organization
VILLAGE FAMILY MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES DAVID WOODCOCK (OWNER/OPERATOR)
(843) 424-5565
Entity
Organization
Contact information
Practice address
3012 NEWCASTLE LOOP, MYRTLE BEACH, SC 29588-4501
(843) 424-5565
Mailing address
3280 PLATTMOOR DR, MYRTLE BEACH, SC 29588-7718
(843) 424-5565
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1977
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285650085
INDIVIDUAL NPI
SC
Enumeration date
06/22/2013
Last updated
06/22/2013
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